Symptoms
Swelling and pain in the small joints of the hands, wrists and feet, prolonged morning stiffness and fatigue.
Diagnosis
Joint examination, rheumatoid factor, anti-CCP antibodies, inflammatory markers and imaging. A negative rheumatoid factor does not exclude the disease.
Treatment
Disease-modifying antirheumatic drugs (DMARDs) such as methotrexate, and biologic or targeted synthetic therapies when indicated, following a treat-to-target strategy.
When to seek advice
With persistent joint swelling or prolonged stiffness of recent onset.
Related content
A hot, very painful and swollen joint, especially with fever, requires urgent medical attention.